Inspection on 27/04/05 for Fernbank House

This inspection was carried out on 27th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fernbank House 19/03/09

Fernbank House 21/03/07

Fernbank House 18/10/05

Fernbank House 08/12/04

Fernbank House 01/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE FERNBANK HOUSE Torrs Park Ilfracombe Devon EX34 8AZ Lead Inspector Susan Taylor Announced 27 April 05 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Fernbank House Address Torrs Park Ilfracombe Devon EX34 8AZ 01271 866166 01271 866166 None Trevor William Leek Mrs Susan Lorraine Leek Mrs Susan Lorraine Leek Care Home 11 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of Dementia - over 65 years of age (11), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (11), Old age, not falling within any other category (11) FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: That the registered manager is Mrs Susan Lorraine Leek. When either of the residents currently sharing Room 8 leaves the home, the registered person will notify the Commission in writingand the particulars and conditions of this registration will revert to those held on the 21st June 2004 Date of last inspection 8th December 2004 Brief Description of the Service: Fernbank House is a care home for up to eleven older people who may also have dementia or mental illness. Twenty-four hour personal care is provided for service users.The house is a detached Edwardian Villa set in a conservation area of the town. There is a sloping drive leading up to the entrance with level access. Seating areas are placed strategically around the gardens, which have various focal points.With the exception of one bedroom, all are single. Ensuite facilities are available in seven bedrooms. The rooms vary in size and outlook. The accommodation is situated on three floors all served by chairlifts. There is level access on each floor. The accommodation is comfortably furnished and well decorated. FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took six hours over one day. Records, and policies and procedures were examined. Five out of eleven residents gave their views of the home to the inspector. Comment cards were received from four relatives and four residents. Three staff, including an agency carer and the owners were spoken to during the day. The people living at Fernbank House told the inspector that they preferred to be referred to as ‘residents’. This term is used throughout the report. What the service does well: What has improved since the last inspection? What they could do better: FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 6 Staff are being employed without all of the proper checks to ensure that they are suitable to work with residents. The owner/manager said that this would be put right immediately. Residents need to know whether the home is meeting it’s own standards. Results of questionnaires need to be shared with residents, relatives, other professionals and the Commission. The owners said that this would be done by the end of June this year. Bedroom windows on the first and second floors need to be regularly checked. This ensures residents safety, and prevents any accidental falls from windows. The owners said that this would be put right immediately. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 6 Fernbank provides residents with exactly what is stated in the service users guide. Needs are well known, and met for residents by a competent team of carers. EVIDENCE: FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 9 • • • • • • • The inspector observed that every resident had a copy of the statement of purpose and service user’s guide in their room. These documents document are laid out in large print, and provide detailed information about: accommodation, facilities, admission criteria, organisational structure and terms & conditions of residency. Two files demonstrated that the admission procedure was thorough. Comprehensive assessments were seen on files, completed by a care manager. A copy of the care plan produced for care management purposes was also on file. In addition to this, Sue Leek had undertaken in-house assessments that had established what each individual’s nutritional, social, physical, psychological needs were. This is excellent practice, and exceeds the minimum standards. Sue Leek told the inspector that intermediate care is not currently provided at Fernbank House. The inspector spoke to five out of eleven residents and was told that they were satisfied with their care and that their needs were well met. Comments included: “The care is second to none” and “You couldn’t find a better place”. Four relatives responded in comment cards. Their comments included: “Excellent care.” “She is happy and well looked after.” “It is an excellent care home.” “The staff are friendly and always ready to listen and help in any way they can.” FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 Fernbank House staff are responsive to the changing needs of their residents. They make good use of health and social care resources available to them in the community to ensure that residents receive the best care available. Residents are treated with dignity and respect. EVIDENCE: • • Care plans were well-maintained, accessible to residents and had been kept under review. Good outcomes were observed when the inspector tracked the care for one resident. The person’s care plan clearly identified risks with regard to eating and drinking, and set out a strategy for minimising those risks. One to one care was given at mealtimes, in an unhurried way. One person told the inspector that the district nurse visited them regularly to re-dress their leg and that it was healing well. Records demonstrated that the home had good relationships with other social and healthcare professionals. Two residents told the inspector that the staff had arranged for them to see a dentist. • • • FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 11 • • • • Staff told the inspector that a dentist visits the home regularly to see residents. Staff knocked before entering bedrooms, and were kind and caring. Frosted windows in some doors had privacy curtains in situ Screening was provided between bed spaces in shared rooms. FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 Residents live in comfortable accommodation that is suitable for their needs and is maintained to a high standard. EVIDENCE: FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 15 • • • • • • • • • • The home was maintained to a high standard, and spotlessly clean. Routine maintenance had been carried out to the heating, gas & fire precaution systems and equipment. Staff and residents told the inspector that prompt action was always taken in respect of maintenance. The grounds were tidy, and attractive with herbaceous perennials and shrubs. The total communal space available provides at least 4.1m² for each service user. The accommodation provided comfortable, homely fittings and fixtures. Seven bedrooms have ensuite facilities. Residents told the inspector that the home has a no smoking policy. However, arrangements had been made to enable one resident who chooses to smoke to do so in a small conservatory to the side of the home. A variety of specialist equipment was seen being used by service users around the home: pressure relieving mattresses on beds and chairs; walking frames; chairlifts; wheelchairs; handling belts and turntables. Call bells were seen in every bedroom. These were in full working order. Comments from residents were positive about the home: “I’m very satisfied here, the home is clean and warm and beautifully kept.” “The house is cleaned from top to bottom every day.” FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 Problems recruiting new staff had had little impact on residents, whose needs were well met. Recruitment procedures had not been followed, and therefore residents were not protected. EVIDENCE: FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 17 • • • • • • • • On the day of the inspection two staff had called in sick leaving Mr. & Mrs Leek having to take over their roles for the day. Agency staff were called in to cover staff sickness from midday. Mr. & Mrs. Leek told the inspector that two staff had recently left, and that recruitment of suitably qualified and experienced staff was proving difficult. Though aware of this, residents felt that this had had little impact on them, and that their needs were well met because of the involvement of Mr. & Mrs Leek. Throughout the day staff were observed to have time to carry out their duties. Four relatives in their comment cards verified that stated that in their opinion there was always enough staff on duty. The duty rosters accurately recorded the names of staff, and duties that had been worked. Staff told the inspector that they enjoyed their work and felt well supported. Two out of three staff files did not contain two written references, photographs or a CRB certificate that had been obtained by Mr. & Mrs Leek. A requirement is made in respect of this. The application for the home was basic, and did not require applicants to provide proof of identity; details of any criminal offences; documentary evidence of any relevant qualifications and training; a full employment history, together with a satisfactory written explanation of any gaps in employment; details and evidence of registration with, or membership of, any professional body FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,36,38 The quality assurance systems in the home need further development, to ensure that residents participate fully in the process. The induction procedures for new staff had improved, and ensure that they are appropriately supervised. Health and safety is promoted at Fernbank. EVIDENCE: • • • • There was an open atmosphere in the home, in which residents were consulted about virtually every matter affecting them. Every resident had a copy of the last inspection report, and one was available in the entrance hall. Letters of thanks with positive comments including “very contented” and “Thank you for making Mother’s birthday so special.” Mr. & Mrs Leek showed the inspector survey responses and a draft summary of the findings. Mrs. Leek said that she had been unable to publish this due to having to cover staff sickness and vacancies. The D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 19 FERNBANK HOUSE • • • • • • • inspector agreed to extend the timescale requiring the quality assurance findings to be published. Comprehensive induction records were seen for two staff, demonstrating that the home had improved procedures since the last inspection. The electrical system had been inspected, and was deemed safe until May 2007. Engineer’s reports showed that regular maintenance was carried out to the stair lifts, and other equipment in the home. Manual handling training had been provided for staff in October 2004. Mr. Leek holds two qualifications in Health & Safety. Fire training had been provided for all staff by an external trainer in April 2005. Windows from the 1st floor level and above, including the landing window had been fitted with restrictors. With exception of bedrooms 3 and 8 the maximum opening had been set at approx 8cms, which is in line with Health & Safety Executive guidelines. A requirement is made in respect of this. FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 2 x x 3 x 2 FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 29 Regulation 19(1)b(i) Requirement The registered person shall not allow a person to whom paragraph (2) applies to work at the care home in a position to which paragraph (3) applies, unless— (b) the employer has obtained in respect of that person the information and documents specified in— (i) paragraphs [1 to 9] of Schedule 2 The registered person shall supply to the Commission a report in respect of any review conducted by him for the purposes of paragraph (1), and make a copy of the report available to service users. (Previous timescale of 31/1/05 not met) The registered person shall ensure that— (c) unnecessary risks to the health or safety of service users are identified and so far as possible eliminated FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 22 Timescale for action By 30/7/05 2. 33 24(2) By 30/6/05 3. 38 13(4)c By 13/5/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 29 Good Practice Recommendations The application for employment needs to be reviewed. This should require applicants to provide: Proof of identity, including a recent photograph; Details of any criminal offences— (a) of which the person has been convicted, including details of any convictions which are spent within the meaning of section 1 of the Rehabilitation of Offenders Act 1974 and which may be disclosed by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions Order) 1975; or (b) in respect of which he has been cautioned by a constable and which, at the time the caution was given, he admitted; Two written references, including, where applicable, a reference relating to the person’s last period of employment, which involved work with children or vulnerable adults, of not less than three months duration; Where a person has previously worked in a position which involved contact with children or vulnerable adults, written verification of the reason why he ceased to work in that position unless it is not reasonably practicable to obtain such verification; Documentary evidence of any relevant qualifications and trainingA full employment history, together with a satisfactory written explanation of any gaps in employment; Details and evidence of registration with, or membership of, any professional body FERNBANK HOUSE D54-D07 S55784 Fernbank House V214748 270405 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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